title: No gender-related differences in the severity of nephropathia epidemica, Germany.
abstract: BACKGROUND
  The number of cases of hantavirus disease caused by Puumala virus is increasing enormously in Germany within the last years. Men are overrepresented in hantavirus disease and differences in course and symptoms in relation to gender were reported from several countries. This study was conducted to define possible gender-specific risk factors and aspects of severity in hantavirus infections occurring in Germany.
  
  
  METHODS
  Characteristics, clinical parameters and symptoms were recorded in a retrospective analysis of 108 patients with serologically confirmed hantavirus infection treated in our department. This cohort corresponds in regard to age, time of infection and gender ratio to the characteristics of the overall cases reported in Germany.
  
  
  RESULTS
  The frequency of characteristic symptoms of hantavirus disease did not differ between males and females. The median of nadir and peak levels of clinical parameters did not exhibit relevant differences that would point to a more severe course in males or females. The clinical course and duration of hospitalization were similar for both sexes. No relevant differences in renal and pulmonary findings were observed. Males with hantavirus disease exhibited more cardiac findings than females.To compare the unequal gender distribution of the rodent-borne Puumala hantavirus disease with the gender ratio of other infectious diseases, we analyzed the gender ratio for notifiable infections according to their mode of transmission. Our data revealed a general overrepresentation of men in infections carried by arthropods and rodents.
  
  
  CONCLUSIONS
  In contrast to reports from other countries, no crucial differences in the symptoms, course or severity of hantavirus disease between infected men and female were observed in our cohort. However behavioural differences may account for the fact that men are more often affected by certain infectious diseases than females.
authors.affiliation: Department of Nephrology, University of Heidelberg, Im Neuenheimer Feld 162, 69120 Heidelberg, Germany. ellen.krautkraemer@med.uni-heidelberg.de.
authors.forename: Ellen
authors.initials: E
authors.lastname: Krautkrämer
authors.forename: Stephan
authors.initials: S
authors.lastname: Grouls
authors.forename: Eva
authors.initials: E
authors.lastname: Urban
authors.forename: Paul
authors.initials: P
authors.lastname: Schnitzler
authors.forename: Martin
authors.initials: M
authors.lastname: Zeier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005858:Germany; D006476:Orthohantavirus / Q000302:isolation & purification / Q000502:physiology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult